Human Rights Watch recently reported that eight countries in Africa and the Middle East used forced anal exams to convict men and transwomen suspected of homosexuality. These countries include Cameroon, Egypt, Kenya, Lebanon, Tunisia, Turkmenistan, Uganda, and Zambia, and the exams are basically a form of state-sponsored sexual assault and torture against suspected gays, bisexuals and transgender people.

What are forced anal examinations like?

These forced anal exams are not like routine prostate examinations where patients willingly drop trou to let a kindly doctor stick in a gentle finger. One 21-year-old man in Tunisia was pushed down onto his knees and bent over (his arms restrained) while another man undid his pants so a doctor could insert a finger and a tube into his anus. Examining doctors do not have to introduce themselves and can allow anyone they want to into the room to assist or observe. In some cases, the doctors take photographs while the victim’s buttocks are forcibly spread open.

What are the exams looking for?

Ostensibly, the doctors are searching for “evidence” of homosexuality like a loose or funnel-shaped anus; lesions, redness, inflammation of anal tissue or traces of sperm, but lacking sperm, a loose anus isn’t proof of anything. Independent Forensic Experts Group (IFEG), a group of 35 international forensic doctors have called the examinations useless, stating that at least 15 other medical conditions unrelated to anal sex can cause rectal conditions that supposedly “prove” a person’s homosexuality. IFEG also says that the exams cause psychological damage that lasts for years beyond the exam itself.

Do the exams really prove that a person had anal intercourse?

Truth is that these examinations aren’t really to “confirm” a person’s suspected homosexuality so much as to humiliate and intimidate anyone suspected of having LGBT sympathies. Refusing the anal examination can be seen as obstructing an investigation and used in cases as proof of a person’s guilt.

What is gay life like in countries where these exams occur?

Cameroon punishes same-sex sexual activity with five years in prison and fines of $33 to $330. In 2013 , two men were imprisoned simply for having “feminine” clothing and speech and ordering drinks with “cream-based” liquor.

Even though homosexuality is not technically illegal in Egypt, in December 2014, 26 men were arrested in a raid on a Cairo bathhouse and charged with “debauchery”, a vague “public morals” law often used to persecute LGBT people. The charges on all the men were later acquitted.

In Kenya, same-sex sexual activity is punishable by up to 14 years in prison and anti-LGBT mob violence is common with aggressors confident that they will face no punishments for killing or injuring known LGBT people.

While Lebanon decriminalized same-sex intercourse in 2014, Article 534 of the country’s penal code still prohibits any sex that “contradict(s) the laws of nature”. The law (and raids on gay meeting places) is used to harass gay, bisexual and trans people or to admit them into police custody for other forms of abuse and torture.

Tunisia punishes same-sex sexual activity with three years imprisonment. In Turkmenistan, gay sex can get you two years in prison and even forced containment in a psychiatric facility to “cure” your homosexuality.

Uganda punishes same-sex intercourse with life imprisonment. Zambia punishes it with 14 years in prison; LGBT people there report widespread discrimination, harassment and fear by anyone who would report them to the authorities.